瓜蒌薤白桂枝汤治疗痰浊内阻型冠心病稳定型心绞痛的临床观察  

Clinical Observation on Gualou Xiebai Guizhi Decoction in the Treatment of Stable Angina Pectoris of Coronary Heart Disease with Turbid Phlegm Obstruction Type

作　　者：刘桉君 陈会君[2] LIU An-Jun;CHEN Hui-Jun(Heilongjiang University of Chinese Medicine,Harbin 150040 Heilongjiang,China;The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150001 Heilongjiang,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第二医院,黑龙江哈尔滨150001

出　　处：《广州中医药大学学报》2021年第12期2565-2571,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：黑龙江中医药大学优秀青年学术带头人支持计划(编号:2018RCD23);黑龙江中医药大学“优秀创新人才支持计划”项目;第四批全国中医(临床、基础)优秀人才研修项目(编号:J20184832009);黑龙江省普通高等学校青年学术骨干支持计划项目(编号:1253G054)。

摘　　要：【目的】观察瓜蒌薤白桂枝汤治疗痰浊内阻型冠心病稳定型心绞痛的临床疗效。【方法】将60例痰浊内阻型冠心病稳定型心绞痛患者随机分为对照组和治疗组,每组各30例。对照组给予常规西药治疗,治疗组在对照组的常规治疗基础上加用瓜蒌薤白桂枝汤治疗,疗程为4周。观察2组患者治疗前后心绞痛发作情况、中医证候积分和血脂水平的变化情况,评价2组患者的心电图疗效、中医证候疗效和安全性。【结果】(1)治疗4周后,治疗组心电图疗效和中医证候疗效的总有效率分别为83.33%(25/30)和90.00%(27/30),对照组分别为56.67%(17/30)和73.33%(22/30),组间比较,治疗组的心电图疗效和中医证候疗效均明显优于对照组(P<0.05)。(2)治疗后,2组患者的心绞痛每周发作次数均较治疗前减少(P<0.05),每次持续时间均较治疗前缩短(P<0.05),且治疗组对心绞痛每周发作次数和每次持续时间的改善作用均明显优于对照组(P<0.05)。(3)治疗后,2组患者的中医证候积分均较治疗前明显降低(P<0.05),且治疗组对中医证候积分的降低作用明显优于对照组(P<0.05)。(4)治疗后,2组患者血清甘油三酯(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)水平均较治疗前下降(P<0.05),高密度脂蛋白胆固醇(HDL-C)水平均较治疗前升高(P<0.05),且治疗组对血清TG、TC、LDL-C水平的降低作用及对血清HDL-C水平的升高作用均明显优于对照组(P<0.05)。(5)治疗过程中,2组患者均未出现不良反应。【结论】瓜蒌薤白桂枝汤治疗痰浊内阻型冠心病稳定型心绞痛临床疗效显著,能有效减轻临床症状,改善心电图情况,调节血脂水平,且具有较高的安全性。Objective To observe the clinical effect on Gualou Xiebai Guizhi Decoction in the treatment of stable angina pectoris of coronary heart disease with turbid phlegm obstruction type. Methods Sixty patients with stable angina pectoris of coronary heart disease with turbid phlegm obstruction type were randomly divided into the control group and the treatment group,30 cases in each group. The control group was treated with conventional western medicine,while the treatment group was treated with Gualou Xiebai Guizhi Decoction on the basis of treatment for the control group. The course of treatment lasted for 4 weeks. Before and after treatment,the angina attack,TCM syndrome scores and blood lipid level of the two groups were observed. And the electrocardiogram efficacy,TCM syndrome efficacy and clinical safety of the two groups were also evaluated. Results(1) After 4 weeks of treatment,the total effective rate of electrocardiogram efficacy and TCM syndrome efficacy in the treatment group was 83.33%(25/30)and 90.00%(27/30)respectively,and that in the control group was 56.67%(17/30)and73.33%(22/30)respectively. The electrocardiogram efficacy and TCM syndrome efficacy of the treatment group were significantly superior to those of the control group(P < 0.05).(2)After treatment,the frequency of weekly attacks of angina pectoris in the two groups was reduced compared with that before treatment(P < 0.05),and the duration of each attack was shortened compared with that before treatment(P < 0.05). The treatment group had stronger effect on improving the weekly attacks and duration of angina pectoris than the control group(P < 0.05).(3)After treatment,the TCM syndrome scores of both groups were significantly decreased compared with those before treatment(P < 0.05),and the effect on decreasing the TCM syndrome scores in the treatment group was significantly superior to that in the control group(P < 0.05).(4)After treatment,the levels of serum triglyceride(TG),total cholesterol(TC)and low-density lipoprotein cholesterol(LDL-C)in t

关 键 词：瓜蒌薤白桂枝汤 冠心病稳定型心绞痛 痰浊内阻型 血脂 

分 类 号：R259.414[医药卫生—中西医结合]